A dozen appointments missed, que sera sera

Recently, Manx Radio reported “twelve people missed appointments at [the] orthopaedic clinic”. I acknowledge that in the eyes of some, it might be ‘only’ a dozen people – but for those dozen people, the medical attention that they need is everything. I think it is, however, just another example of the poor service that too many people receive from our Government services.

The news that hospital letters were not delivered to patients for an “unknown reason” is a dismal example of the endemic failure in public services, and the Isle of Man’s healthcare system appears to be stuck in a bureaucratic time warp. The fact that this is even a headline in 2024, when we have myriad technological tools to avoid such basic errors, is absurd. It’s as though the idea of email, secure electronic communications, or even SMS has yet to penetrate the walls of the hospital. Are we really still relying on the postal system for critical medical communications?

You wouldn’t accept this level of communication service when you made an book to get your hair cut. You wouldn’t accept this level of communication service when you made arrangements to have lunch with a friend. You wouldn’t accept this level of communication service when you made a booking for a flight. So why do we accept this level of communication service when we receive an appointment time dictated by Manx Care?

This entire debacle is presented as an unfortunate inevitability, a mere mishap of fate, with no real examination of the broken system that has allowed it to happen. The passivity in the face of such failures is infuriating. It’s not just about the letters going missing—it’s about the complete lack of foresight and initiative on the part of those in charge. If the leadership had any serious intent to improve patient care, they’d have long since transitioned to a more reliable, accountable system of communication. But instead, we get this defeatist “unknown reason” as though the situation were akin to some natural disaster rather than a direct result of outdated practices and organisational ineptitude.

This is just another symptom of a deeper issue. The government structures, including healthcare management, suffer from a chronic case of having no skin in the game. When there are no real consequences for failure, mediocrity festers. Where are the incentives for doing a good job? Where is the accountability for doing a terrible one? No one is held responsible when these letters go missing, no one is losing their position or facing any form of scrutiny. The system is designed to diffuse responsibility so broadly that no single individual or department ever feels the pressure to improve. It’s no surprise that these sorts of failures keep happening. Why bother pushing for change when doing nothing is enough to keep your job?

The whole “unknown reason” excuse is just a cover for the absence of real leadership. Leaders in the system should be held accountable for these preventable problems—missing critical medical communications isn’t just a glitch, it’s a failure of responsibility. But in our government and public services, failure is treated as a benign event with no repercussions, leaving patients at risk and wasting public resources.